Glycosuriá: Normal urine contains negligible amount of

gludose, which is too insignificant to be detected

by Benedict's
reduction test. But when sugar is present in urine in sufficient
concentration so as to give a positive result with Benedict's rea-
gent, the condition is known as glycosuria or glucosuria.
Under
normal conditions, glucose is completely reabsorbed bythe renal
tubules, by a phosphorylation mechanism which is catalysed by
an enzyme system. This mechanism functions
normally as ong as
the glucose in blood is well below
the capacity of the tubular
enzyme system to reabsorb it. But when the glucose level in blood
increased beyond the capacity of the tubular
with it, the excess
mechanism to deal
glucose escapes in the urine, causing glycosuria.
The renal threshold value for
glucose, beyond which glucose
appears in urine to cause glycosuria, varies from person to person,
but on, an average, it
ranges from160 to 180 mg % It is gener
ally higher in older people and inpeople with diseased kidreys.
We
say, that renal threshold value is high,
when the blood glu-
cose is abnormally high, with very little or no excretion of glu-
cose in the urine. Glycosuria can occur in two conditions. (1) In
hyperglycemia, (2) In normoglycemia.
In hyperglycemia, glycosuria may be due to either decreased
secretion of insulin, as in diabetes mellitus, or due to hyper
activity of the hormones of anterior pituitary, adrenal medulla,
adrenal cortex and thyroid.
In normoglycemia, glycosuria may occur due to physio
logical or hereditary causes.

(a) Physiological Glycosuria includes alimentary glycosuria,

emotional glycosuria, glycosuria in pregnancy and lactating
glycosuria.
Alimentary Glycosuria: Certain individuals with normal blood
glucose may excrete glucose in urine after taking large
amounts
of
of glucose o r carbohydrates. This may be due to a rapid rate
as it often happens after
absorption of glucose into the blood
stomach. During
surgical removal of a considerable part of the
cannot keeP pace with the
such conditions, the liver and muscle
to glycogen. This
conversion of the rapidly absorbed glucose
and is harmless.
results in glycosuria. It is temporary
Emotional Glycosuria: Transient hyperglycemia causing glyco-
factors like fear, anger and anxiety.
suria may follow emotional
subsides after the emotional factor is
This is temporary and
of release of adrenaline which
removed. Glycosuria is the result
causes hyperglycemia by promoting glycogenolysis.
occur in
Pregnancy and Lactating Glycosuria: Glycosuria may
filtration and
late pregnancy due to increased rate of glomerular
lactation. The latter is due
to the excretiðn of tactosein the-urine.
 The blood glucose is normal. Glycosuria disappears after cessa-
tion of pregnancy lactation.
(b) Hereditary Glycosuria refers to Renal glycosuria (Renal
diabetes). This is a condition where glucose is excreted in the
urine of individuals who do not show high blood glucose values
or any abnormality in carbohydrate metabolism. They are other
wise healthy. Administration of a standard dose of glucose does
not indicate blood
glucose values higher than in normal subjects,
and their glucose tolerance curves are normal. Most of these cases
detected accidentally. The defect lies in the
are

epzyme mechanism which s responsible

renal tubular
for reabsorption of
glucose. Deficiency of the enzyme causes an impairment in the
capacity to reabsorb glucose from the filtered urine and hence
the glycosuria. It is a hereditary defect, affecting several members
of the same family.